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Gazi AH, Wittbrodt MT, Harrison AB, Sundararaj S, Gurel NZ, Nye JA, Shah AJ, Vaccarino V, Bremner JD, Inan OT. Robust Estimation of Respiratory Variability Uncovers Correlates of Limbic Brain Activity and Transcutaneous Cervical Vagus Nerve Stimulation in the Context of Traumatic Stress. IEEE Trans Biomed Eng 2022; 69:849-859. [PMID: 34449355 PMCID: PMC8853700 DOI: 10.1109/tbme.2021.3108135] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Variations in respiration patterns are a characteristic response to distress due to underlying neurorespiratory couplings. Yet, no work to date has quantified respiration pattern variability (RPV) in the context of traumatic stress and studied its functional neural correlates - this analysis aims to address this gap. METHODS Fifty human subjects with prior traumatic experiences (24 with posttraumatic stress disorder (PTSD)) completed a ∼3-hr protocol involving personalized traumatic scripts and active/sham (double-blind) transcutaneous cervical vagus nerve stimulation (tcVNS). High-resolution positron emission tomography functional neuroimages, electrocardiogram (ECG), and respiratory effort (RSP) data were collected during the protocol. Supplementing the RSP signal with ECG-derived respiration for quality assessment and timing extraction, RPV metrics were quantified and analyzed. Specifically, correlation analyses were performed using neuroactivity in selected limbic regions, and responses to active and sham tcVNS were compared. RESULTS The single-lag unscaled autocorrelation of respiration rate correlated negatively with left amygdala activity and positively with right rostromedial prefrontal cortex (rmPFC) activity for non-PTSD; it also correlated negatively with left and right insulae activity and positively with right rmPFC activity for PTSD. The single-lag unscaled autocorrelation of expiration time was greater following active stimulation for non-PTSD. CONCLUSION Quantifying RPV is of demonstrable importance to assessing trauma-induced changes in neural function and tcVNS effects on respiratory physiology. SIGNIFICANCE This is the first demonstration of RPV's pertinence to traumatic stress- and tcVNS-induced neurorespiratory responses. The open-source processing pipeline elucidated herein uniquely includes both RSP and ECG-derived respiration signals for quality assessment, timing estimation, and RPV extraction.
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Affiliation(s)
- Asim H. Gazi
- School of Electrical and Computer Engineering, S. Sundararaj is with the College of Sciences, Atlanta, GA 30308 USA
| | - Matthew T. Wittbrodt
- Department of Anesthesiology, School of Medicine, Northwestern University, Chicago, IL 60611,Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322
| | - Anna B. Harrison
- School of Electrical and Computer Engineering, S. Sundararaj is with the College of Sciences, Atlanta, GA 30308 USA
| | | | - Nil Z. Gurel
- David Geffen School of Medicine at UCLA, Los Angeles, CA 90095
| | - Jonathon A. Nye
- Department of Radiology, Emory University School of Medicine, Atlanta, GA 30322
| | - Amit J. Shah
- Department of Epidemiology, Rollins School of Public Health, Atlanta, GA 30322,Department of Internal Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA 30322,Atlanta VA Medical Center, Emory University, Atlanta, GA 30322
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Atlanta, GA 30322,Department of Internal Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA 30322
| | - J. Douglas Bremner
- Department of Radiology, Emory University School of Medicine, Atlanta, GA 30322,Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322,Atlanta VA Medical Center, Emory University, Atlanta, GA 30322
| | - Omer T. Inan
- School of Electrical and Computer Engineering, S. Sundararaj is with the College of Sciences,Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30308 USA
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